Proposed Topic (Most preferred): :
HA Young Investigators Session (Projects to be presented by HA staff who had joined HA for 10 years or less)
Proposed Topic (Second preferred): :
Clinical Safety and Quality Service II (Projects aiming to enhance clinical safety and outcomes, clinical governance / risk management)
Authors (including presenting author) :
Ip KFS (1), Cheung YF (1), Chan CF (1), Cheung CSB (1), IP KY (1)
Affiliation :
(1) Nutrition Support Team, Department of Surgery, North District Hospital
Introduction :
Malnutrition, cancer-related cachexia, and sarcopenia are prevalent among gastric cancer patients, significantly impacting treatment outcomes. Traditional measures like body weight and body mass index (BMI) have limitations in assessing muscle strength and function. Computed tomography (CT) scans offer a more accurate evaluation of skeletal muscle index (SMI), enabling the identification of high-risk patients with sarcopenia who could benefit from prehabilitation. However, the role of SMI in the Asian population, particularly in Hong Kong, remains underexplored. This retrospective cohort study aims to investigate the predictive value of SMI in survival outcomes after gastrectomy for gastric cancer, focusing on the local context. Understanding the relationship between SMI and surgical outcomes can aid in risk stratification and personalizing patient care in our population.
Objectives :
To evaluate the predictive value of SMI on overall survival in patients with gastric cancer undergoing gastrectomy. Secondary objectives include assessing the impact of SMI on disease-free survival, postoperative complications, and clinicopathological factors.
Methodology :
A total of 68 patients consisting of 51 males and 17 females aged 46 to 83 years, who underwent curative gastrectomy for gastric cancer between September 2018 and August 2023 at North District Hospital were included. SMI was calculated as skeletal muscle mass at the L3 vertebra level on CT divided by the square of body height. Sarcopenia was defined using gender-specific cut-off values suggested by Prado (38.5 cm2 /m2 for females and 52.4 cm2 /m2 for males). Kaplan-Meier analysis and log-rank tests were performed to compare overall survival rates between sarcopenic and non-sarcopenic patients.
Result & Outcome :
The average SMI for males and females was 50.0 cm^2/m^2 and 43.4 cm^2/m^2, respectively. Sarcopenia was observed in 45.6% of patients. Sarcopenic patients had significantly poorer overall survival compared to non-sarcopenic patients (mean survival time 43.0 vs. 57.3 months, p=0.03). No significant associations were found between SMI and length of hospital stay, postoperative complications, or 30-day mortality. SMI is a useful predictor of survival after gastrectomy for gastric cancer in Hong Kong. Further research is warranted to establish appropriate SMI cut-off values for Asian populations, investigate its applicability in different surgical settings, and assess its utility in patient triage for prehabilitation programs.
